Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.
The main goal was to evaluate effectiveness of a modified TSE sequence compared with DIR (double inversion recovery) sequence in acquisition of fast flow brain vessel images using signal void effect. 32 healthy volunteers (10 men and 22 women; mean age of 31 years; ranging between 28-43 years) who underwent black blood DIR sequence (group A) and the modified TSE sequence (group B) were enrolled in our study. Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) of the internal carotid arteries' lumen were compared in T1 and T2 weighted images for both group A and B. The images obtained from group B showed lower SNR values in internal carotid artery than the group A in both of the T1 and T2 weighted images (11.49% and 13.66% respectively). While the CNR values were higher in the group B than the group A in both of the T1 and T2 weighted images (8.69% and 7.55 % respectively). The qualitative score of all categories were not significantly different between the two groups. Furthermore approximately 49% of the total scan time was reduced from group B. Our study is to shorten the scanning time and minimize the inconveniences of the patients in acquisition of the black blood images of brain by using the signal void effect in the modified TSE technique while keeping the diagnostic value of the test.
Park, Seok-Gun;Lee, Yeon-Hee;Rhyu, Jin-Woo;You, Sun-Mee
The Korean Journal of Nuclear Medicine
/
v.32
no.2
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pp.151-160
/
1998
Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.
Pulmonary perfusion scan with radioactive $^{113m}In$-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of mitral stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of atrial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductus arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.
In order to collect information on local distribution of conductivity and permittivity underneath a scan probe, we developed a multi-frequency trans-admittance scanner (TAS). Applying a sinusoidal voltage with variable frequency on a chosen distal part of a human body, we measure exit currents from 320 grounded electrodes placed on a chosen surface of the subject. The electrodes are packaged inside a small and light scan probe. The system includes one voltage source and 17 digital ammeters. Front-end of each ammeter is a current-to-voltage converter with virtual grounding of a chosen electrode. The rest of the ammeter is a voltmeter performing digital phase-sensitive demodulation. Using resistor loads, we calibrate the system including the scan probe to compensate frequency-dependent variability of current measurements and also inter-channel variability among multiple. We found that SNR of each ammeter is about 85dB and the minimal measurable current is 5nA. Using saline phantoms with objects made from TX-151, we verified the performance of the lesion estimation algorithm. The error rate of the depth estimation was about 19.7%. For the size estimate, the error rate was about 15.3%. The results suggest improvement in lesion estimation algorithm based on multi-frequency trans-admittance data.
The Journal of Korean Institute of Communications and Information Sciences
/
v.35
no.5B
/
pp.753-761
/
2010
In this paper, we propose a novel tag collection algorithm to improve tag collection performance in active RFID systems. In the proposed algorithm, the reader detects the occurrence of empty slots and collided slots through the identified slot scan process and reduces the time wasted by empty slots and collided slots, resulting in improvement of tag collection performance. To evaluate the performance improvement by the proposed tag collection algorithm via the experiments in a real-world environment, we implemented an active RFID reader and tags. The experimental results with the reader and 60 tags showed that the proposed algorithm could reduce the average tag collection time by 21.7% and improve the average identification throughput by 28.3%, compared with the standard tag collection algorithm in ISO/IEC 18000-7. In addition, the proposed algorithm reduced the average battery consumption on tags by 22.7% in the battery consumption experiment with 20 tags.
As a part of the KIAPS Observation Processing System (KOPS), we have developed the modules of satellite radiance data pre-processing and quality control, which include observation operators to interpolate model state variables into radiances in observation space. AMSU-A (Advanced Microwave Sounding Unit-A) level-1d radiance data have been extracted using the BUFR (Binary Universal Form for the Representation of meteorological data) decoder and a first guess has been calculated with RTTOV (Radiative Transfer for TIROS Operational Vertical Sounder) version 10.2. For initial quality checks, the pixels contaminated by large amounts of cloud liquid water, heavy precipitation, and sea ice have been removed. Channels for assimilation, rejection, or monitoring have been respectively selected for different surface types since the errors from the skin temperature are caused by inaccurate surface emissivity. Correcting the bias caused by errors in the instruments and radiative transfer model is crucial in radiance data pre-processing. We have developed bias correction modules in two steps based on 30-day innovation statistics (observed radiance minus background; O-B). The scan bias correction has been calculated individually for each channel, satellite, and scan position. Then a multiple linear regression of the scan-bias-corrected innovations with several predictors has been employed to correct the airmass bias.
In the past few years, scintigraphy has become increasingly important in clinical practice, and the use of a color-printing technique has permited a more accurate interpretation of the scan image. Our liver color scintigrams consist of 51 hepatomas, 35 liver cirrhosis, 22 liver abscessis, 10 hepatitis and other 13 cases of the liver diseases which were clinically arid pathologically diagnosed at Sevarance Hospital, Yonsei Univ., since Feb. 1969 through Sept. 1969. These scintigrams have been analized in terms of various pathologic morphology, such as size, shape, margin of the liver, distribution of radioactivity, and shape of the space occupying lesions. The results are as follows: 1. Enlargement of the liver was the most common finding in the diseased livers. The Rt. lobe enlargement was particularly prominent in the liver abscess. 2. Irregular distribution of radioactivity in the liver (so called mottling) was present in 78% of hepatoma, while it was seen only in 31% of liver abscesses. 3. Liver cirrhosis tends to show perihilar accumulation of the isotope (57%). 4. The deformity of the lower most angle of the Rt. lobe, and the Lt. lateral margin of the Lt. lobe was also impressive throughout the cases ($74{\sim}95%$ of all diseased livers). 5. The frequency of visualization of the spleen was influenced by the size of space occupying lesions and the amount of functioning liver. 6. Differentiation between the liver abscess and hepatoma seems to be possible on scintigram, when shape and margin of defect and patterns of distribution of radioactivity in the remaining liver are clearly demonstrated.
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in South Korea. To decrease its mortality rate, its early detection is very important. Screening for HCC detection has been accepted as the management modality for patients with chronic liver disease. Reported herein is a case involving the marked rapid growth of HCC detected at an advanced stage in a screening test with a 3 months interval. A 49-year-old male patient with chronic hepatitis B was admitted to the hospital due to a liver mass detected on CT scan. The patient underwent a first CT scan 3 months earlier, and no tumor was detected. Follow-up CT scan was performed and showed a 9.1 cm HCC with portal vein thrombosis. Percutaneous liver biopsy was performed, and the diagnosis of hepatocellular carcinoma was confirmed. In the pertinent guidelines, the recommended screening interval for HCC is 6-12 months, but the screening interval and additional diagnostic methods should be considered due to the variation in the HCC growth rate according to the patient's clinical characteristics.
Purpose : To determine if ultrasonography is a reliable technique to assess masseter muscle sites within intra- and interobserver and the scanning level and/or the muscle condition affect local cross-sectional dismension (LCSD) measurements of masseter muscle. Materials and Methods : 10 subjects without sign and symptom of temporomandibular disorders and missing posterior teeth were examined by ultrasonography. Bilateral ultrasonographic examinations were performed with a linear (B-scan) 7.5 MHz small-part transducer to register LCSDS of the masseter muscle on three different levels. Scans were made on relaxed and clenching condition. Three oral and maxillofacial radiologists measured at two sessions with a time interval of at least 5 minutes. Results : Variables such as 'condition' and 'level' had a significant effect on muscle measurements (p<0.05). There was no significant difference between 'sessions'(p>0.05) and 'observers' (p>0.05). LCSDS on lower scan level were significantly thinner than those on upper and middle level. Those on clenching condition were significantly thicker than those on relaxed condition (p<0.05). The scanning level with the highest reproducibility was middle with clenching condition (ICC=0.90, $MSE=0.55\%$). Conclusion : The data suggested that ultrasonography was a reliable method for measuring LSCD of masseter muscle in intra- and Interobserver and middle scan level showed the most reliable data.
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